VANESSA LEE JACO CRNP NPI 1114049095

NPI Information

NPI: 1114049095
Provider Name: VANESSA LEE JACO, CRNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
37 BALL PARK RD
HARLAN, KY
ZIP 40831
Phone: (606) 573-4520
Get Directions

Vanessa Lee Jaco, CRNP is an acute care nurse practitioner in Harlan, KY with 24 years of experience. Vanessa Lee Jaco, CRNP NPI is 1114049095. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduation Year:2000

The provider's business location address is:

37 BALL PARK RD
HARLAN, KY
ZIP 40831-701
Phone: (606) 573-4520

The NPI 1114049095 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/4/2007 and was last updated on 11/21/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	1-087710	ALABAMA	No
2	363LA2100X	Nurse Practitioner	Acute Care	4010950	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	112805	MEDICAID	ALABAMA
2	51515966	OTHER	ALABAMA	BCBS
3	510-49323	OTHER	ALABAMA	BCBS
4	112809	MEDICAID	ALABAMA
5	510-49324	OTHER	ALABAMA	BCBS
6	515-98704	OTHER	ALABAMA	BCBS
7	051553292	MEDICAID	ALABAMA
8	112804	MEDICAID	ALABAMA
9	112806	MEDICAID	ALABAMA
10	510-49321	OTHER	ALABAMA	BCBS
11	510-49322	OTHER	ALABAMA	BCBS
12	510-49443	OTHER	ALABAMA	BCBS
13	P00015330	OTHER	ALABAMA	RAILROAD MEDICARE
14	112813	MEDICAID	ALABAMA
15	112815	MEDICAID	ALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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